• Archives of Plastic Surgery
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• v.38 no.4
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• pp.383-390
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• 2011

Purpose: To correct the upper lip depression after the correction of unilateral cleft lip, autologous grafts such as bone, dermal, fascial grafts and fat injections or alloplastic implants are used. Transplanted bones, dermis and fascia have a tendency to be absorbed and have donor morbidity. Fat injections are absorbed inconsistently and alloplastic implants have problems such as foreign body reactions, protrusions and infections. Authors corrected the upper lip depression using conchal cartilage graft in unilateral cleft lip deformity and the results was analysed with photos. Methods: 26-unilateral cleft lip and 2-microform cleft lip cases, totally 28 cases were performed. Their mean age was 21.89 years. The male and female cases were 12 and 16, respectively. Under anesthesia (general: 18 cases and local: 10 cases), cavum conchae (n=8), cymba conchae (n=16) and whole conchae (n=4) were harvested. Transversely cut the margin of the obtained cartilage, we cut out the most bent portion and put a partial-thickness incision on concave surface in cases of excessive convexity. Then, we performed the onlay graft of the conchal cartilage via scar revision site in unilateral cleft lip and via the reconstruction site of the cupid bow in microform cleft lip. The augmentation of the upper lip was evaluated with photos. Adapting the baseline connecting between the both cheilions as a horizontal standard line, we measured the highest point among the tangents between the upper lip and nose (point a), the lowest point (point c), the middle point between a and c (point b) and the vertical line from the alare (point d) to the horizontal standard line. To assess the postoperative symmetry, we compared cleft side upper lip contour index (%) A,B,C,D=(a,b,c,d)-ch ${\times}$ 100/(ch-ch) and non-cleft side upper lip contour index (%) A',B',C',D'= (a',b',c',d')-ch ${\times}$ 100 / (ch-ch).h) Results: After the surgery, no complication was found except in one case which double layers graft performed in the cleft lip deformity, the lateral portion was protruded. The upper lip contour index, the difference of A and A' were-0.83%, and thus the mild depression was persisted. Difference of B and B', C and C', D and D' were 0.83%, 1.07%, 0.90%. There were statistically significant difference, and thus the depression of upper lip were improved generally. Conclusion: Authors performed the onlay graft of the conchal cartilage in unilateral cleft lip deformity and found that the depression of the upper lip was well corrected except the uppermost part when photogrammetrically analyzed.

• Imaging Science in Dentistry
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• v.38 no.4
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• pp.229-231
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• 2008

Brown tumor is a histologically benign lesion that is a serious complication of renal osteodystrophy because it may result in severe deformity and discomfort. We report a case of brown tumor, which occurred in a 35-year-old woman with chronic renal failure, who had been treated with hemodialysis for 14 years. The lesion was found on the lingual side of the mandible. Standard panoramic radiograph showed generally decreased bone mineral density, loss of lamina dura, and thin cortical plates. Computed tomography (CT) revealed multilocular expansile lesions with heterogeneous attenuation in the anterior mandible, as well as generalized trabecular alteration with homogeneous sclerosis, and thinning or obliteration of cortical plates. Excision of the mandibular lesion and curettage of the affected bone were performed. (Korean J Oral Maxillofac Radiol 2008; 38: 229-31)

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.336-342
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• 2019

Purpose: To examine the relationship between the progression of a kyphotic deformity and the magnetic resonance imaging (MRI) findings in conservatively treated osteoporotic thoracolumbar compression fracture patients. Materials and Methods: This study categorized the patients who underwent conservative treatment among those patients who underwent treatment under the suspicion of a thoracolumbar compression fracture from January 2007 to March 2016. Among them, this retrospective study included eighty-nine patients with osteoporosis and osteopenia with a bone density of less than -2.0 and single vertebral body fracture. This study examined the MRI of anterior longitudinal ligament or posterior longitudinal ligament injury, superior or inferior endplate disruption, superior of inferior intravertebral disc injury, the presence of low signal intensity on T2-weighted images, and bone edema of intravertebral bodies in fractured intravertebral bodies. Results: In cases where the superior endplate was disrupted or the level of bone edema of the intravertebral bodies was high, the kyphotic angle, wedge angle, and anterior vertebral compression showed remarkably progression. In the case of damage to the anterior longitudinal ligament or the superior disc, only the kyphotic angle was markedly prominent. On the T2-weighted images, low signal intensity lesions showed a high wedge angle and high anterior vertebral compression. On the other hand, there were no significant correlations among the posterior longitudinal ligament injury, inferior endplate disruption, inferior disc injury, and the progression of kyphotic deformity and vertebral compression. The risk factors that increase the kyphotic angle by more than 5° include the presence of injuries to the anterior longitudinal ligament, superior endplate disruption, and superior disc injury, and the risk factors were 21.3, 5.1, and 8.5 times higher than those of the uninjured case, and the risk differed according to the level of bone edema. Conclusion: An osteoporotic thoracolumbar compression fracture in osteoporotic or osteopenic patients, anterior longitudinal ligament injury, superior endplate and intravertebral disc injury, and high level of edema in the MRI were critical factors that increases the risk of kyphotic deformity.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.4
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• pp.338-345
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• 1993

Mandibular discontinuity defect due to benign tumor, malignant tumor, infection, or truma results in major esthetic and biologic compromise. The primary goal of reconstruction is full restitution of function, which secondarily lead to normalization of the cosmetic deformity. The authors make a clinical study of 61 consecutive bone graft cases for mandibular reconstruction of discontinuity defect which were studied retrospectively using clinical data and radiographic findings. The cases were reviewed to evaluate the clinical success in the period from 1981 to 1990 in the Dept. of Oral & maxillofacial Surgery, Seoul National University Hospital. The criteria of the success in bone graft, are no residual infection, graft in with maintain its integrity, and remain over a half of its original size of graft in the radiographic features. The purpose of this clinical survey is to study of the mandibular discontinuity defects and success rate of free bone graft in mandibular defects. To summarize the clinical study of free bone graft, the main type of autogenous bone graft is iliac bone and corticocancellous type. Overall success rate is 80.3% in 61 followup cases over 6 months. Wire fixation and Extraoral approach has realtively better prognosis than other methods. It showed relatively poor prognosis in symphysis defects than other recipient site.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.589-596
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• 2008

Purpose: The nasal bone fracture is most common fracture in facial bone injuries. Regardless of the severity or type of fracture, closed reduction has traditionally been the common method of treatment. However, through detailed pre-operative evaluation, we found out that many patients consider rhinoplasty prior to trauma due to aesthetic desire or nasal deformity with or without septal deviation. In treatment of nasal bone fracture, we focused not only on the fracture management but also on the patients' desire prior to trauma, and we made additional operation according to patients' desire with fracture reduction and gained rewarding outcomes. Methods: From March 2005 to June 2007, total 263 patients were treated for nasal bone fracture. Among these patients, 57 patients (21%) had the additional operation with nasal fracture reduction. The additional operations were categorized in three types: augmentation rhinoplasty with tip plasty (40%), septoplasty only (16%), corrective rhinoplasty (44%). The mean follow-up period was 5.6 months and results were evaluated by scoring. Results: Forty four of 57 patients (77%) were highly satisfied regardless of any additional operation kinds. The complications were one septal perforation, two displacement of implant and four remnant nasal deformities. For the septal perforation, no further management was performed because we lost the contact with the patient. Then 4 of the other complicated patients were revised. Conclusion: In general, many physicians tend to consider nasal fracture as a simple trauma. However through the strict history taking, physical examination and professional counseling, we could catch the patient's cosmetic desire and get the eyes on new concept: the nasal fracture is not only a trauma but a cosmetic and functional field. In the treatment of nasal bone fracture, if additional rhinoplasty is performed, patients will be more satisfied and we also can expect higher profits.

• Proceedings of the KSME Conference
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• 2007.05a
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• pp.746-750
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• 2007

Vertebroplasty has drawn much attention as a medical treatment for the compression fracture of spine, which strengthens the vertebral body and corrects deformity, and relieves pain in patients by injecting bone cement. However vertebroplasty can cause fracture on adjacent vertebra due to relative stiffness change. This study involves the biomechanical evaluation of the vertebroplasty especially on adjacent vertebral body. The finite element method has been employed to analyze the patient who was treated vertebroplasty under static and dynamic loading. For this study, a three-dimentioal model of the three-level ligamentous lumbar segment ($L1{\sim}L3$)is created from medical image data (CT)and compared with the experimental results in vitro.

• Journal of the Korean Arthroscopy Society
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• v.2 no.1
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• pp.59-63
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• 1998

There have been numerous methods to obtain a stable arthrodesis of the tibiotalar joint. However, a controvercy has arisen over the most successful and reproducible method to obtain an arthrodesis. The objective of this report is to show that an ankle arthrodesis can be performed successfully and advantageously by using cannulated screws under arthroscopic control and that our csaes will be a part of the multicentric study of arthroscopic ankle arthrodesis in korea. Between May 1996 and May 1997, we perfomed 3 ankle arthrodesis under arthroscopy using cannulated screws. Two patients had post-traumatic osteoarthritis and one had rheumatoid arthritis. Clinical ankylosis in one case and radiological union in two cases were obtained in 12 weeks postoperatively. We propose that arthroscopic ankle arthrodesis is effective procedure in patient who has minimal deformity and bone loss, advantages like small incision, minimal morbidity, low infection rate and rapid return to normal daily activity, but more cases and comparision with open tecnique will be needed.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2001.11a
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• pp.14-20
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• 2001

Rheumatoid arthritis (RA) is one of the most typical rheumatic diseases, and is characterized by chronic inflammation, cartilage destruction and joint deformity ［1,2］. During this process, profound hypertrophic changes of the synovium with infiltration of immune cells, increased vascularity, and hyperplasia result in the formation of a synovial pannus that invades cartilage and bone ［3］. In early stages of RA, the synovial membrane begins to invade the cartilage. In established RA, the synovial membrane becomes transformed into inflammatory tissue, the pannus (Fig. 1). The cell types that occupy cartilage-pannus junctions include synovial macrophages, fibroblasts, mast cells, polymorphonuclear lymphocytes (PMNs), and displaced, probably differentiated condrocytes ［4-6］. Recent studies of rheumatoid synovial tissue have demonstrated localized accumulations of mast cells and evidence of their activation/degranulation［7］.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.14 no.2
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• pp.16-24
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• 2008

Anatomy: Advanced knowledges of cellular and molecular biology led to the development of therapies of rheumatoid arthritis(RA). Rheumatoid arthritis (RA) is a chronic, recurrent, systemic inflammatory disease and results in major deformity or dysfunction of joints. Etiology: Rheumatoid arthritis is now concevied as autoimmune disease. There have been many trials to define the immunological changes in rheumatoid arthritis. But now pathogenesis and significance of immunoglobulin complement and rheumatoid factor are not full accepted. Syndrome: Joints are characteristically involved with early inflammatory changes in the synovial membrane, peripheral portions of the articular cartilage, and lation tissue(pannus) forms, covers, and erodes the articular cartilage, bone and ligaments within the jiont capsule. Inflammatory changes also occur in tendon sheaths(tenosynovitis), and if subjected to a lot of friction, the tendons may fray or rupture. Extra-articular pathological changes sometimes occur, these include rheumatoid nodules, atrophy and fibrosis of muscles, and mild cardiac changes. Treatment: Tumor necrosis factor(TNF) inhibitor for the treatment of rheumatoid arthritis(RA) induces not only significant improvement of symptoms and signs of RA but also substantial inhibition of progressive joint damage.

• Imaging Science in Dentistry
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• v.36 no.3
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• pp.157-162
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• 2006

Familial gigantiform cementoma is a rare fibre-cemento-osseous disease of the jaws which appears to be transmitted as an autosomal dominant trait with variable expressivity of the phenotype. A 7-year-old girl visited DKUDH complaining of the painless facial deformity. Clinically, significant facio-lingual expansion was observed at the left maxilla, left mandibular body and symphysis portion. Malposition of lower anterior teeth was found. Panoramic radiograph and CT scan showed the extensive expansile mixed lesion at maxilla and mandible. Bone scan revealed hot spot at the maxilla and left side of mandible. Histologic examination revealed moderately dense fibrous connective tissue with scattered masses resembling cementum. The patient's mother had a history of the mandibular resection due to benign tumor. Her younger brother had buccal expansion of right mandible. We report our finding of a family that has exhibited clinical, radiographic and histologic findings consistent with the familial gigantiform cementoma.